Low incidence of red cell and HLA antibody formation by bone marrow transplant patients

Abou-Elella, A; Camarillo, T A; Allen, Martin; Barclay, Sheilagh; Pierce, John A.; Holland, H. Kent; Wingard, John R.; Bray, Robert A.; Rodey, Glenn E.; Hillyer, Christopher D.

doi:10.1046/j.1537-2995.1995.351196110898.x

Cited by 56 publications

(42 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We provide further evidence for an increased risk of alloimmunization in SCD compared to the general population, independent of the cumulative transfusion exposure [5,6,11,39,41]. This susceptibility for alloimmunization in SCD has previously been explained by the antigenic differences between donors and recipients, SCD specific factors such as chronic inflammation and patient-related factors such as genetic background [2].…”

Section: Discussionmentioning

confidence: 58%

Early occurrence of red blood cell alloimmunization in patients with sickle cell disease

et al. 2016

View full text Add to dashboard Cite

Red blood cell (RBC) alloimmunization is a major complication of transfusion therapy in sickle cell disease (SCD). Identification of high-risk patients is hampered by lack of studies that take the cumulative transfusion exposure into account. In this retrospective cohort study among previously non-transfused SCD patients in the Netherlands, we aimed to elucidate the association between the cumulative transfusion exposure, first alloimmunization and independent risk factors. A total of 245 patients received 11 952 RBC units. Alloimmunization occurred in 43 patients (18%), half of them formed their first alloantibody before the 8th unit. In patients with exposure to non-extended matched transfusions (ABO and RhD) the cumulative alloimmunization risk increased up to 35% after 60 transfused units. This was significantly higher compared to a general transfused population (HR 6.6, CI 4.2-10.6). Receiving the first transfusion after the age of 5 was an independent risk factor for alloimmunization (HR 2.3, CI 1.0-5.1). Incidental, episodic transfusions in comparison to chronic scheme transfusions (HR 2.3, CI 0.9-6.0), and exposure to non-extended matched units in comparison to extended matching (HR 2.0, CI 0.9-4.6) seemed to confer a higher alloimmunization risk. The majority of first alloantibodies are formed after minor transfusion exposure, substantiating suggestions of a responder phenotype in SCD and stressing the need for risk factor identification. In this study, older age at first transfusion, episodic transfusions and non-extended matched transfusions appeared to be risk factors for alloimmunization.

show abstract

Section: Discussionmentioning

confidence: 58%

Early occurrence of red blood cell alloimmunization in patients with sickle cell disease

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Moreover, to mount a primary immune response, B lymphocytes need T lymphocytes, which are usually inactive during the first 6 months post transplant. [6][7][8] Such cases have rarely been reported in the literature. 4 The clinical impli-cations emphasize the importance of close immuno-hematological monitoring, in patients undergoing allogenic BMT with ABO-RhD incompatibility.…”

Section: Discussionmentioning

confidence: 99%

Transmission of an anti-RhD alloantibody from donor to recipient after ABO-incompatible BMT

Franchini

Gironcoli

Gandini

et al. 1998

Bone Marrow Transplant

View full text Add to dashboard Cite

Summary:We report a bone marrow transplant which was HLA matched, with major and minor ABO and minor RhD incompatibility (anti-RhD antibody) between the donor and recipient. When engraftment occurred, the recipient developed an anti-RhD antibody of donor origin detected by direct and indirect antiglobulin tests (DAT, IAT) and showed signs of mild hemolytic anemia. With the disappearance of the recipient RBCs, the DAT became negative and the hemolysis disappeared, while the anti-RhD alloantibody persisted in the patient's serum. This case emphasizes the importance of close immuno-hematological monitoring in patients undergoing allogeneic BMT with ABO-RhD incompatibility between recipient and donor. Keywords: bone marrow transplantation; ABO-RhD incompatibility; alloantibody; hemolytic anemia A 50-year-old male patient, affected by AML (FAB M5), was referred to us for a BMT from his HLA-identical sister, during his first complete remission after chemotherapy. His pre-transplant RBC phenotype was B CcDee (anti-A titer: IgM 256, IgG 128). Antibody screening (indirect antiglobulin test (IAT) ) and direct antiglobulin test (DAT) were negative. The bone marrow donor was a 40-year-old female, whose RBC phenotype was A ccdee (anti-B titer: IgM 512, IgG 64). The IAT showed the presence of an anti-RhD alloantibody, titer 2. This woman had had no pregnancies and had received blood transfusions a few years previously because of a severe anemia due to a uterine hemorrhage.The patient underwent conditioning therapy in July 1996 with hyperfractioned TBI and high-dosage CY. He subsequently received his sister's bone marrow: 1380 ml of marrow were collected from the donor's iliac crests. Due to the major and minor ABO incompatibility, the plasma was removed from the harvested bone marrow by spinning at 4000 r.p.m. × 10 min, and then the bone marrow was isovolumetrically re-suspended in saline 0.9% and the RBC were removed by sedimentation in 12.5% hydroxyethyl starch. A 636 ml suspension of bone marrow cells with a few red cells (equivalent to 15 ml of whole blood with 40% hematocrit) was obtained. The bone marrow was re-infused into the recipient through a central venous catheter, at a rate of 160 ml/h (infusion time: 4 h). During the aplasic period the patient received 9 units of group O Rh-negative RBC, 12 units of single donor platelets (group AB) and 24 units of random pool platelets (group O), that had been re-suspended in 0.9% saline after the plasma had been removed. All blood products were irradiated to 24 Gy and filtered (RXCL 1 PALL filters for RBC and PL 100 PALL filters for platelets). On day 24, the platelets were Ͼ20 × 10 9 /l and the granulocytes Ͼ0.5 × 10 9 /l; a bone marrrow smear confirmed engraftment. The DAT was weakly positive (IgG+, C3dϪ), while the IAT remained negative; an eluate was inconclusive. RBC ABO grouping test showed the presence of RBC from two different blood groups: group O from RBC transfusions and group B from the recipient. Serum ABO grouping was only positive with A 1 RBC. The anti-A 1 (Ig...

show abstract

“…Abou-Elella et al 55 studied 192 patients, of whom 148 received autologous transplantation. Seven patients had alloantibodies before transplantation and an additional four (2.1%) developed new alloantibodies.…”

Section: Does Incompatibility For Non-abo Red Cell Antigens Affect Trmentioning

confidence: 99%

Red blood cell-incompatible allogeneic hematopoietic progenitor cell transplantation

Rowley

Donato

Bhattacharyya

2011

Bone Marrow Transplant

121

104

View full text Add to dashboard Cite

Low incidence of red cell and HLA antibody formation by bone marrow transplant patients

Cited by 56 publications

References 26 publications

Early occurrence of red blood cell alloimmunization in patients with sickle cell disease

Early occurrence of red blood cell alloimmunization in patients with sickle cell disease

Transmission of an anti-RhD alloantibody from donor to recipient after ABO-incompatible BMT

Red blood cell-incompatible allogeneic hematopoietic progenitor cell transplantation

Contact Info

Product

Resources

About